Organization
FAMILY CHILD & ADOLESCENT PSYCHIATRIC SERVICES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILA B AQUINO (MEDICAL BILLING SERVICE)
(951) 282-0060
Entity
Organization
Contact information
Practice address
1 OLD FRANKFORT WAY, FRANKFORT, IL 60423-1719
(708) 206-1300
(708) 206-1399
Mailing address
833 W 15TH PL, UNIT 815, CHICAGO, IL 60608-1429
(708) 206-1300
(708) 206-1399
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036067468
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018896
VALUEOPTIONS PROVIDER #
IL
01
—
036067468
LICENSE #
IL
05
—
036067468
—
IL
01
—
119475
COMPSYCH PROVIDER #
IL
01
—
155000
PSYCHEALTH PROVIDER #
IL
01
—
166548
HARMONY PROVIDER #
IL
01
—
3103879
BCBS
IL
01
—
31603879
BCBS PROVIDER #
IL
01
—
35928
AMERICAID PROVIDER #
IL
Enumeration date
10/26/2006
Last updated
05/11/2021
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